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Background:The first hours and weeks of life are the most critical for neonatal survival, and the most important time for recognising illnesses and timely care seeking, yet postnatal care utilisation continues to have the lowest coverage of interventions on the continuum of maternal and child care. There is a need to evaluate the current evidence on facilitators and barriers to postnatal care utilisation in low- and middle-income countries in order to design and improve health programmes. The objective of this review is to systematically assess reported barriers to postnatal care utilisation by mothers/caregivers/healthcare users and create a Cochrane/EPOC study to do so.

Methods: This review (currently ongoing, but expected to be completed before September) will identify studies from 1970 to the present with published abstracts in English, Spanish, French and Portuguese. Databases include MEDLINE (Pubmed), CINAHL, EMBASE and Cochrane, as well as ancestry search. Study selection criteria include the research setting and study design. Our primary outcome is reported facilitators and barriers to postnatal care utilisation. Two independent researchers are conducting the screening, data abstraction and scientific quality assessment, using standardised extraction forms. Where feasible, results are stratified by countries’ income level or geographic region.

Results: Over 300 articles were screened for inclusion; the final numbers and results will be presented in September. This analysis fills the gap between the maternal and pediatric reviews that have been previously conducted.

Conclusions: Our review will inform health policy programmes by identifying the most common facilitators and barriers to postnatal care utilisation. This research will highlight how programmes can improve access to postnatal care utilisation in low- and middle-income countries to advance sustainable gains in global maternal and neonatal health. It will also inform how to carry out a mixed-methods systematic review and collaborate with Cochrane and the EPOC group.